Intervention Review

Nedocromil sodium for preventing exercise-induced bronchoconstriction

  1. Carol Spooner1,*,
  2. L. Duncan Saunders2,
  3. Brian H Rowe3

Editorial Group: Cochrane Airways Group

Published Online: 21 JAN 2002

Assessed as up-to-date: 6 AUG 2008

DOI: 10.1002/14651858.CD001183


How to Cite

Spooner C, Saunders LD, Rowe BH. Nedocromil sodium for preventing exercise-induced bronchoconstriction. Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD001183. DOI: 10.1002/14651858.CD001183.

Author Information

  1. 1

    1G1.52 Walter Mackenzie Health Centre, Division of Emergency Medicine, Edmonton, Alberta, Canada

  2. 2

    Faculty of Medicine and Dentistry, University of Alberta, Department of Public Health Sciences, Edmonton, Alberta, Canada

  3. 3

    University of Alberta, Department of Emergency Medicine, Edmonton, Alberta, Canada

*Carol Spooner, Division of Emergency Medicine, 1G1.52 Walter Mackenzie Health Centre, 8440 - 112 ST, Edmonton, Alberta, T6G 2B7, Canada. cspooner@ualberta.ca.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2002

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Exercise-induced bronchoconstriction (EIB) following strenuous physical exertion afflicts many people. It can be the cause of sub-optimal performance, symptoms such as cough, dyspnea, wheeze and chest tightness, and can lead people to avoid physical activity. Management of EIB focuses on prevention through pharmacotherapy and alternate strategies. Single use, pre-exercise, beta-agonists and non-steroidal antiinflammatory agents are recommended.

Objectives

Bronchodilator medications have been commonly used to prevent narrowing of airways after exercise, but anti-inflammatory drugs such as nedocromil sodium have also been used. The objective of this review was to assess the effects of a single dose of nedocromil sodium to prevent exercise-induced bronchoconstriction.

Search methods

We searched the Cochrane Airways Group Specialised Regsiter, the Cochrane Central Register of Controlled Trials, Current Contents, review articles, textbooks and reference lists of articles. We also contacted the drug manufacturer and primary authors for additional citations. Searches have been updated to August 2008.

Selection criteria

Randomised trials comparing a single dose of nedocromil sodium with placebo to prevent exercise-induced bronchoconstriction in patients with EIB over six years of age.

Data collection and analysis

Trial quality assessment and data extraction were conducted independently by two reviewers. Study authors were contacted for confirmation of data. No new studies were identified in an update search conducted in August 2008.

Main results

The combined results from 20 randomised controlled trials involving 280 participants, show that 4 mg, of nedocromil sodium inhaled 15 to 60 minutes prior to exercise significantly reduce the severity and duration of EIB in both adults and children, when compared to placebo. The maximum percentage fall in FEV1 was improved significantly compared to placebo (weighted mean difference 15.5 %; 95% confidence interval:13.2 to 18.1). For the maximum percentage fall in peak expiratory flow rate (PEFR) the improvement was similar: WMD 15.0%, (95% CI 8.3 to 21.6). Nedocromil shortened the time to recover lung normal function from more than 30 minutes with placebo to less than 10 minutes with the drug. It had a greater effect on those patients with more severe exercise-induced bronchoconstriction (defined as an exercise-induced fall in lung function > 30% from baseline). There were no significant adverse effects reported with the short term use of nedocromil. A further search conducted in August 2005 did not yield any further studies.

Authors' conclusions

Nedocromil sodium used before exercise reduces the severity and duration of exercise-induced bronchoconstriction. This effect appears to be more pronounced in people with severe exercise-induced bronchoconstriction.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Nedocromil sodium for preventing exercise-induced bronchoconstriction

Exercise-induced asthma can limit people's endurance, prolong recovery time after exercise, and lead to people avoiding exercise. The episode involves symptoms such as coughing, wheezing, shortness of breath and chest tightness. The review of trials found that nedocromil sodium (Tilade) inhaled 15 to 60 minutes before exercise may reduce the severity and length of this kind of asthma for both adults and children, particularly those who have severe episodes.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

Nedocromil sodium預防運動誘發的支氣管收縮

運動誘發的支氣管收縮(EIB)伴隨著大量的體力消耗,折磨著許多人。它可能是次等的表現、症狀如咳嗽、呼吸困難、喘息和胸悶的原因,並使民眾避免生理活動。EIB的管理注重以透過藥物治療和替代策略來預防。建議於運動前使用單次使用的乙性作用劑和非膽固醇消炎藥物。

目標

支氣管擴張藥物已普遍使用於防止運動後的氣道狹窄,但消炎藥物,如nedocromil sodium也會被使用。這次審查的目標是評估單一劑量nedocromil sodium預防運動引起的支氣管收縮的效果。

搜尋策略

我們檢索了the Cochrane Airways Group Specialised Regsiter,the Cochrane Central Register of Controlled Trials,現有刊物,評論文章,教科書和參考文獻目錄的文章。我們還聯繫了藥品製造商和主要作者以取得額外的文章連結。檢索更新到2007年8月的資料。

選擇標準

隨機試驗用以比較單一劑量nedocromil sodium與安慰劑使用在6歲以上的EIB患者來防止運動誘發的支氣管收縮。

資料收集與分析

試驗品質評估和數據分析是由兩個審查員獨立的進行。聯繫研究的作者以確認數據。在2007年8月進行的更新檢索中並沒有發現新的研究。

主要結論

從 20個包含280位受試者的隨機對照試驗中,綜合所得結果顯示,與使用安慰劑相比,在運動前15至60分鐘,吸入4毫克nedocromil sodium,在成人和兒童病患均大幅降低EIB的嚴重程度和持續時間。FEV1的最大百分比跌幅,表示有明顯的症狀改善當與安慰劑相比(加權平均差15.5%,95%信賴區間:13.2至18.1)。對於尖峰呼氣流速的下降最多百分比(PEFR),其改善結果是相似的:WMD 15.0%,(95%CI為8.3至21.6)。nedocromil sodium縮短恢復肺的正常功能的時間,從服用安慰劑的超過30分鐘,到治療後的不到10分鐘。它對有更嚴重的運動引起的支氣管收縮(定義為因運動引起的肺功能下降>30%的基準)這些患者有更大的影響。沒有重大不良反應的報告有關於短期使用nedocromil sodium。在2005年8月進行的更新檢索中並沒有發現新的研究。

作者結論

運動前使用Nedocromil sodium,降低了運動引起的支氣管收縮的嚴重程度和持續時間。這種影響在有嚴重運動引起的支氣管收縮的病患身上似乎更為顯著。

翻譯人

本摘要由臺北醫學大學萬芳醫院劉怡敏翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

於運動前使用Nedocromil sodium(Tilade),可減少運動引起的氣喘症狀,特別是對那些有嚴重症狀的人. 運動誘發氣喘限制人的耐力,延長運動後的恢復時間,並導致人們避免運動。這一事件涉及的症狀,如咳嗽、氣喘;呼吸急促和胸悶。審查了試驗後發現,運動前吸入Nedocromil sodium(Tilade)15至60分鐘,可以減少有這類氣喘成人和兒童病患的嚴重程度和長度,特別是有嚴重症狀的。